DMA Dispute Management & Avoidance

the comprehensive litigation alternative




Claimant’s Name___________________________

Address___________________________________

City, State & Zip___________________________

Home Phone_______________________________

Office Phone______________________________

Cell Phone________________________________

Fax_______________________________________

E-Mail____________________________________

Respondent’s Name_________________________

Address___________________________________

City, State & Zip___________________________

Home Phone_______________________________

Office Phone______________________________

Cell Phone________________________________

Fax_______________________________________

E-Mail____________________________________

Herein after known as CLAIMANT

Jobsite Address________________________________________________Jobsite Phone___________________

The parties as listed above, hereby jointly agree to Arbitrate their dispute and submit the following issue(s) to binding On Site Arbitration pursuant to the Rules and Procedures of DMA Dispute Management & Avoidance, which shall act as tribunal.

COUNTER CLAIM BY RESPONDENT

Describe the nature of the dispute, attach additional sheets as necessary:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

COUNTERCLAIM OR RELEIF SOUGHT BY RESPONDENT

Describe the claim (dollar amount) or remedy sought (action):

__________________________________________________________________________________________________________________________________________________________________________________________________________________

DEMAND TO ARBITRATE

Please submit a copy of your arbitration clause, your entire evidence package along with this document pursuant to section 13.3 of the Rules and Procedures, & mail to: 800 South P.C.H. Suite 8-281, Redondo Beach, CA 90277 or scan & email to the email address in the website trustDMA.com

I/We agree that the Arbitrators decision shall be binding.  I/We shall abide by any Award rendered hereunder and that a civil judgement may be entered upon the Award.

Respondent Signature_________________________ Date_______________________________________

Herein after known as RESPONDENT

Respondent Signature_________________________ Date_______________________________________

Filing Forms